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. 2019 Jan 15;10(1):1558707.
doi: 10.1080/20008198.2018.1558707. eCollection 2019.

Complicated grief and post-traumatic stress symptom profiles in bereaved earthquake survivors: a latent class analysis

Maarten C Eisma  1 , Lonneke I M Lenferink  1   2 , Amy Y M Chow  3 , Cecilia L W Chan  3 , Jie Li  4
Affiliations

Complicated grief and post-traumatic stress symptom profiles in bereaved earthquake survivors: a latent class analysis

Maarten C Eisma et al. Eur J Psychotraumatol. .

Abstract
in English, Spanish, Chinese

Background: Studies on mental health following disasters have primarily focused on post-traumatic stress disorder (PTSD), yet severe, enduring, and disabling grief [i.e. complicated grief (CG)] also appears relevant. Objective: The present study examines symptom profiles of PTSD and CG among bereaved Sichuan earthquake survivors 1 year after the disaster. Method: Self-report measures of demographic, disaster, and loss-related characteristics and symptoms of PTSD and CG were administered among 803 survivors (63% women; mean age = 46.7 years). Latent class analysis (LCA) was performed to identify subgroups of people with different PTSD and CG symptom profiles. Results: The LCA demonstrated that a five-class solution yielded the best fit, consisting of a CG class with low PTSD and high CG (N = 208), a combined class with high PTSD and high CG (N = 205), a class with low PTSD and partial CG (N = 145), a class with partial PTSD and CG (N = 136), and a resilient class with low PTSD and CG (N = 108). Being a woman (vs man), losing a child or spouse (vs other), being injured (vs non-injured), and/or having a missing family member (vs non-missing) predicted membership of the CG class compared to other classes. Conclusions: CG appears to be a unique consequence of disasters involving many casualties. Disaster survivors should be screened for CG and provided with appropriate psychological treatment.

Antecedentes: Los estudios en la salud mental luego de desastres se ha centrado principalmente en el trastorno de estrés postraumático (TEPT), pero el duelo discapacitante y permanente (por ejemplo, duelo complicado, DC) también pareciera ser importante.Objetivo: El presente estudio examina los perfiles de síntomas de TEPT y DC entre los sobrevivientes del terremoto de Sichuan que perdieron a un ser querido, un año después del desastre.Método: A los 803 sobrevivientes (63% mujeres, edad media = 46,7 años), se les administraron medidas de auto-reporte sobre las características demográficas, del desastre, y relacionadas a la pérdida como también síntomas de TEPT y DC. El análisis de clases latentes (LCA en sus siglas en inglés) fue llevado a cabo para identificar subgrupos de personas con diferentes perfiles de TEPT y DC.Resultados: El LCA demostró que una solución de cinco clases presentó el mejor ajuste, consistiendo de una clase de DC con bajo TEPT y alto DC (N = 208), una clase combinada de alto TEPT y alto DC (N = 205), una clase de bajo TEPT y DC parcial (N = 145), una clase con TEPT y DC parciales (N = 136), y una clase resiliente con bajo TEPT y DC (N = 108). Ser mujer (vs. hombre), perder un hijo/a o cónyuge (vs. otro), estar lesionado/a (vs. no lesionado/a), y/o tener a un familiar perdido (vs. no perdido) predijeron la pertenencia a la clase del DC comparado a las otras clases.Conclusiones: El DC surge como una consecuencia única de los desastres involucrando a muchas víctimas. Los sobrevivientes de desastres deberían ser pesquisados por DC y tener acceso a tratamiento psicológico adecuado.

背景：有关灾难的研究通常都关注创伤后应激障碍（PTSD），然而持续而强烈的哀伤（即，复杂哀伤，CG）也同样值得关注。目的：本研究探索四川地震一年以后，失去亲人的灾民们的PTSD 和CG症状情况。方法：共有803名丧亲的灾民（63%是女性，平均年龄47岁）完成了自我报告的问卷，内容包括人口学变量，与灾难和丧失有关的情况，以及测量PTSD与CG的问卷。用潜分类分析（LCA）来检测被试的PTSD与CG 症状分组情况。结果：分析结果表明被试的最佳分类是5组，包括CG组：低PTSD和高CG （N = 208），混合组：高PTSD及高CG （N = 205），一组低PTSD和部分CG（N =145），一组部分PTSD和CG (N = 136)，以及复原组：低PTSD低CG（N = 108）。女性（相比男性），失去孩子或配偶（相比失去其他人），有家庭成员失踪（相比无失踪），有家庭成员失踪（相比无失踪）能预测CG组（相对于其他组而言）。结论：在有人员伤亡的灾难中，CG是单独呈现的一组症状。灾难幸存者的CG情况应该被筛查并给予相应的支持。.

Keywords: Prolonged grief disorder; Wenchuan earthquake; bereavement; persistent complex bereavement disorder; trauma.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Estimated post-traumatic stress disorder (PTSD) and complicated grief (CG) symptom probabilities for the five-class latent class analysis solution.
See this image and copyright information in PMC

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